RT Journal Article T1 Cost-Effectiveness of Next-Generation Sequencing Versus Single-Gene Testing for the Molecular Diagnosis of Patients With Metastatic Non-Small-Cell Lung Cancer From the Perspective of Spanish Reference Centers A1 Arriola, Edurne A1 Enguita Valls, Ana Belén A1 López-Ríos Moreno, Fernando A1 Zugazagoitia, Jon A1 Álava, Enrique de AB PurposeThe aim of this study was to assess the cost-effectiveness of using next-generation sequencing (NGS) versus single-gene testing (SgT) for the detection of genetic molecular subtypes and oncogenic markers in patients with advanced non–small-cell lung cancer (NSCLC) in the setting of Spanish reference centers.MethodsA joint model combining decision tree with partitioned survival models was developed. A two-round consensus panel was performed to describe clinical practice of Spanish reference centers, providing data on testing rate, prevalence of alterations, turnaround times, and treatment pathways. Treatment efficacy data and utility values were obtained from the literature. Only direct costs (euros, 2022), obtained from Spanish databases, were included. A lifetime horizon was considered, so a 3% discount rate for future costs and outcomes was considered. Both deterministic and probabilistic sensitivity analyses were performed to assess uncertainty.ResultsA target population of 9,734 patients with advanced NSCLC was estimated. If NGS was used instead of SgT, 1,873 more alterations would be detected and 82 more patients could potentially be enrolled in clinical trials. In the long term, using NGS would provide 1,188 additional quality-adjusted life-years (QALYs) in the target population compared with SgT. On the other hand, the incremental cost of NGS versus SgT in the target population was €21,048,580 euros for a lifetime horizon (€1,333,288 for diagnosis phase only). The obtained incremental cost-utility ratios were €25,895 per QALY gained, below the standard cost-effectiveness thresholds.ConclusionUsing NGS in Spanish reference centers for the molecular diagnosis of patients with metastatic NSCLC would be a cost-effective strategy over SgT. PB American Society of Clinical Oncology SN 2473-4284 YR 2023 FD 2023-03-02 LK https://hdl.handle.net/20.500.14352/118189 UL https://hdl.handle.net/20.500.14352/118189 LA eng NO Edurne Arriola et al., Cost-Effectiveness of Next-Generation Sequencing Versus Single-Gene Testing for the Molecular Diagnosis of Patients With Metastatic Non–Small-Cell Lung Cancer From the Perspective of Spanish Reference Centers. JCO Precis Oncol 7, e2200546(2023). DOI:10.1200/PO.22.00546 DS Docta Complutense RD 6 abr 2025